Isometric Co-Contractions of the Quadriceps and Hamstrings in Intact and PCL-Deficient Knees

1999 ◽  
Author(s):  
Hongzhi Yang ◽  
Yi-Chun Li ◽  
Mohamed Samir Hefzy
Keyword(s):  
Posterior Cruciate Ligament ◽  
Knee Injury ◽  
Surgical Repair ◽  
Cruciate Ligament ◽  
Three Dimensional ◽  
Knee Model ◽  
Number Of Patients ◽  
Significant Disability ◽  
Straight Leg Raise ◽  
Pcl Injury

Abstract The exercises to strengthen the muscles around the knee are designed to improve its stability. During these exercises, co-contraction of the hamstrings occur depending on the level of quadriceps contraction. The purpose of this study is to develop a three-dimensional knee model that includes tibia, femur and patella and allows to predict knee response due to quadriceps and hamstrings co-contractions. As an application, results quantifying the changes in knee response are obtained following a simulated posterior cruciate ligament (PCL) injury. This is motivated by the continuing debate whether surgical repair is the method of choice for individuals with such an injury. It has been reported that following a knee injury, a large number of patients with PCL deficiency develop significant disability with Osteoarthritis (OA). The conditions tested simulate the straight-leg-raise exercise, during which the quadriceps muscles contract isometrically along with hamstrings co-contractions.

scholarly journals Evaluation of Deep Vein Thrombosis Risk Factors After Arthroscopic Posterior Cruciate Ligament Reconstruction: A Retrospective Observational Study

2021 ◽  
Vol 27 ◽  
pp. 107602962110305
Author(s):  
Pu Ying ◽  
Wenge Ding ◽  
Xiaowei Jiang ◽  
Yue Xu ◽  
Yi Xue ◽  
...  
Keyword(s):  
Risk Factors ◽  
Posterior Cruciate Ligament ◽  
Color Doppler ◽  
Cruciate Ligament ◽  
Color Doppler Ultrasound ◽  
Pcl Reconstruction ◽  
Vein Thrombosis ◽  
Post Surgery ◽  
Pcl Injury ◽  
D Dimer

We evaluated the risk factors of deep venous thrombosis (DVT) after knee arthroscopic posterior cruciate ligament (PCL) reconstruction in patients with only PCL injury. From August 2014 to December 2020, a total of 172 patients who had accepted knee arthroscopic PCL reconstruction underwent the color Doppler ultrasound of bilateral lower-extremities deep veins on 3 days postoperatively. Based on the inspection results, patients were divided into DVT group (18 males and 8 females, mean age 43.62 years) and non-DVT group (108 males and 38 females, mean age 33.96 years). The potential associations of DVT risk and age, gender, body mass index (BMI), diabetes, hypertension, smoking and other factors were analyzed. An old age (OR = 1.090; 95% CI = 1.025-1.158; P = 0.006), a high BMI (OR = 1.509; 95% CI = 1.181-1.929; P = 0.001) and an increased post-surgery D-dimer (OR = 5.034; 95% CI = 2.091-12,117; P ≤ 0.001) value were significantly associated with an elevated DVT risk after knee arthroscopic PCL reconstruction. Increased age, BMI, and postoperative D-dimer were risk factors of DVT following knee arthroscopic PCL reconstruction in patients with only PCL injury.

Posterior Cruciate Ligament Reconstruction in the Multiple Ligament Injured Knee

2020 ◽  
Vol 33 (05) ◽  
pp. 421-430
Author(s):  
Michelle E. Kew ◽  
Mark D. Miller
Keyword(s):  
Posterior Cruciate Ligament ◽  
Knee Injury ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Surgical Reconstruction ◽  
Nonsurgical Management ◽  
Injured Knee ◽  
Tibial Inlay ◽  
Low Activity

AbstractMultiligamentous knee injuries are challenging to treat and diagnose. Posterior cruciate ligament (PCL) injuries are commonly found in the constellation of injuries included in a multiligamentous knee injury and are caused by a posteriorly directed force on the proximal tibia with relation to the femoral condyles. A thorough history and physical examination should be performed to evaluate for associated neurovascular injuries and associated ligamentous, chondral, or bony injuries. Nonsurgical management is reserved for patients who are critically ill or have very low activity demands. Surgical reconstruction is recommended for most patients with multiligamentous knee injuries. The PCL reconstruction can be undertaken with several different graft options and reconstruction techniques, including the transtibial, arthroscopic tibial inlay, and open tibial inlay approach. The literature has a paucity of data regarding outcomes among the various reconstructive options, so the optimal surgical technique has not been established.

scholarly journals Posterior cruciate ligament injury is influenced by intercondylar shape and size of tibial eminence

2019 ◽  
Vol 101-B (9) ◽  
pp. 1058-1062
Author(s):  
K. S. R. van Kuijk ◽  
M. Reijman ◽  
S. M. A. Bierma-Zeinstra ◽  
J. H. Waarsing ◽  
D. E. Meuffels
Keyword(s):  
Risk Factors ◽  
Posterior Cruciate Ligament ◽  
Knee Injury ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Control Group ◽  
Anatomical Landmarks ◽  
Shape Modelling ◽  
Tibial Eminence ◽  
Statistical Shape

Aims Little is known about the risk factors that predispose to a rupture of the posterior cruciate ligament (PCL). Identifying risk factors is the first step in trying to prevent a rupture of the PCL from occurring. The morphology of the knee in patients who rupture their PCL may differ from that of control patients. The purpose of this study was to identify any variations in bone morphology that are related to a PCL. Patients and Methods We compared the anteroposterior (AP), lateral, and Rosenberg view radiographs of 94 patients with a ruptured PCL to a control group of 168 patients matched by age, sex, and body mass index (BMI), but with an intact PCL after a knee injury. Statistical shape modelling software was used to assess the shape of the knee and determine any difference in anatomical landmarks. Results We found shape variants on the AP and Rosenberg view radiographs to be significantly different between patients who tore their PCL and those with an intact PCL after a knee injury. Overall, patients who ruptured their PCL have smaller intercondylar notches and smaller tibial eminences than control patients. Conclusion This study shows that differences in the shape of the knee are associated with the presence of a PCL rupture after injury. A smaller and more sharply angled intercondylar notch and a more flattened tibial eminence are related to PCL rupture. This suggests that the morphology of the knee is a risk factor for sustaining a PCL rupture. Cite this article: Bone Joint J 2019;101-B:1058–1062.

Three-Dimensional Characterization of the Femoral Footprint of the Posterior Cruciate Ligament

2013 ◽  
Vol 29 (11) ◽  
pp. 1811-1816 ◽  
Author(s):  
Robert W. Westermann ◽  
Christian Sybrowsky ◽  
Austin J. Ramme ◽  
Annunziato Amendola ◽  
Brian R. Wolf
Keyword(s):  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Three Dimensional

scholarly journals Arthroscopic Standard Anterior and Posteromedial Portal Posterior Cruciate Ligament Reconstruction With Remnant Preservation : 2-Year Follow-up

2020 ◽  
Vol 8 (B) ◽  
pp. 418-422
Author(s):  
Sholahuddin Rhatomy ◽  
Erwin Saspraditya ◽  
Riky Setyawan
Keyword(s):  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
International Knee Documentation Committee ◽  
Pcl Reconstruction ◽  
Remnant Preservation ◽  
Lysholm Knee Score ◽  
Ikdc Score ◽  
Grade 3 ◽  
Pcl Injury

BACKGROUND: Grade 3 posterior cruciate ligament (PCL) injury needs surgical intervention, but there is no consensus on the optimal technique in PCL reconstruction. The old technique always removes the remnant for good visualization of tunnel replacement. Recently, many studies proposed the concept of preservation of PCL remnant with achieve good visualization. AIM: The aim of the study is to evaluate PCL reconstruction with remnant preservation using the standard anterior and posteromedial portal at 2-year follow-up. METHODS: We conducted a cohort retrospective study between January 2013 and December 2015. In this study, 25 patients underwent PCL reconstruction using the standard anterior and posteromedial portal with remnant preservation. We used quadrupled hamstring autograft. The patients were assessed using the International Knee Documentation Committee (IKDC) score, Lysholm Knee Score, Modified Cincinnati Score, and knee society score (KSS) at pre-operative and 2-year post-operative. Range of motion (ROM) and complications were evaluated postoperatively. RESULTS: The mean diameter of the quadruple hamstring graft was 8 mm. Clinical outcomes enhanced significantly (p < 0.05). The average of Lysholm activity scale improved from 65.12 ± 10.48 to 94.96 ± 4.80. The IKDC score improved from 60.50 ± 15.10 to 95.60 ± 3.44. Modified Cincinnati score improved from 62. 28 ± 13.6 to 96.04 ± 1.62. The KSS also improved from 60.12 ± 18.01 to 94.88 ± 6.36. Twenty-two patients had 0–135° full ROM and three patients had 0–110° ROM. Two patients had surgical site infection but recovered with local debridement. CONCLUSION: PCL reconstruction using the standard anterior and posteromedial portal with remnant preservation at 2-year follow-up resulted in satisfactory clinical and functional outcomes.

Common risk factors of deep vein thrombosis after arthroscopic posterior cruciate ligament reconstruction: a 5-year retrospective study

2020 ◽  
Author(s):  
Dai Xiaoyu ◽  
Ding Wenge ◽  
Li Huan ◽  
Peng Xu ◽  
Wang Kejie ◽  
...  
Keyword(s):  
Risk Factors ◽  
Posterior Cruciate Ligament ◽  
Color Doppler ◽  
Cruciate Ligament ◽  
Color Doppler Ultrasound ◽  
Pcl Reconstruction ◽  
Post Surgery ◽  
Common Risk Factors ◽  
Pcl Injury ◽  
D Dimer

Abstract Background To analyse the common risk factors of deep venous thrombosis (DVT) after knee arthroscopic posterior cruciate ligament (PCL) reconstruction in patients with PCL injury. Methods From August 2014 to December 2019, a total of 86 patients who had accepted knee arthroscopic PCL reconstruction underwent the color Doppler ultrasound of bilateral lower-extremities deep veins on 3 days postoperatively. Based on the inspection results, patients were divided into DVT group (9 males and 4 females, mean age 43.62 years) and non-DVT group (54 males and 19 females, mean age 33.96 years). The potential associations of DVT risk and age, gender, body mass index (BMI), diabetes, hypertension, smoking and other factors were analysed. Results High BMI and post-surgery D-dimer values were significantly associated with DVT risk. Conclusions Increased BMI and postoperative D-dimer levels are risk factors of DVT following knee arthroscopic PCL reconstruction in patients with PCL injury.

scholarly journals The Effects of the Functional Garment on the Biomechanics During the Single Leg Drop Landing.

2021 ◽  
Author(s):  
Shintarou Kudo ◽  
Ayane Yamamoto ◽  
Sho Katayama ◽  
Toshinori Miyashita ◽  
Raita Takasaki
Keyword(s):  
Lower Limb ◽  
Knee Injury ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Three Dimensional ◽  
Human Movement ◽  
Knee Valgus ◽  
Drop Landing ◽  
Significant Difference ◽  
Study Characteristics

Abstract Background: Female athletes with an anterior cruciate ligament (ACL) injury should decrease both dynamic valgus of the knee and related kinematics of the lower limb during single leg drop landing (SLDL). A functional biomechanics garment (FBG) may help prevent injury by improved kinematics during motion. The purpose of this study was to investigate the effects of the FBG on the biomechanics of SLDL.Methods: Seventeen female university basketball players participated in this study. Characteristics of the FBG were designed based on biomechanics during weight-loaded performance of human movement such as gait, running, and jumping. Lower limb kinematic and kinetic data were calculated using a three-dimensional motion analysis system during a SLDL task with and without the FBG. The hip, knee, and ankle angles and joint moments were automatically calculated from the standard plug-in gait lower body model. The average values of lower limb kinematics and kinetics in the sagittal and frontal planes from 3 SLDL with and without FBG were measured and compared.Results: The maximum varus angle of the knee showed a significant difference between with FBG (15.3±15.1 degrees) and without FBG (5.9±15.4 degrees). (p<0.01; effect size 0.6) Conclusion: Use of the FBG decreases dynamic knee valgus, which reduces risk of knee injury. The FBG can reduce dynamic knee valgus during SLDL in athletic rehabilitation and to play a role in the prevention of knee injury.

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